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Public Expenditure (public + expenditure)
Selected AbstractsThe Distribution of Public Expenditure across the UK RegionsFISCAL STUDIES, Issue 1 2003Iain McLean Abstract The distribution of UK revenue to the regional and territorial governments, administrations and authorities that spend the money is based on a hotchpotch of badly designed formulae. This is widely recognised. The Barnett formula, which allocates money to the devolved territories, has been attacked from all sides, its consequences described as ,terribly unfair' by its progenitor, Lord Barnett. The mechanism by which resources are distributed to local authorities within the English regions has been abandoned by the government, although its replacement has not yet been determined. This paper argues that a common basis for government spending across the regions and territories of the UK will be more equitable and efficient, and may even depoliticise the financial framework of the UK. [source] The Distributional Effects of Public ExpenditureJOURNAL OF ECONOMIC SURVEYS, Issue 3 2000Gerd Schwartz It is commonly agreed that economic policies, including budgetary policies, can have potentially strong distributional effects. Traditional economic analysis held that economic policies affected the income distribution primarily through their impact on the rate of growth. More recently, it has come to be recognised that qualitative aspects of economic growth are probably more important than the rate of growth itself. While recent research has confirmed the potential role of expenditure policies as a redistributive tool, it has also shown that redistribution does not necessarily have to come at the expense of economic growth and efficiency. Although there are substantial analytical and technical problems to be faced in the design of equitable and cost-effective public expenditure programmes, unfavourable distributional outcomes of these programmes can usually be traced more to political and institutional pressures than to purely technical factors. JEL Classification number: H5 [source] Low Public Expenditures on Social Welfare: Do East Asian Countries have a Secret?INTERNATIONAL JOURNAL OF SOCIAL WELFARE, Issue 1 2000David Jacobs This paper explores the sources of low public expenditures on social welfare in Japan, Korea, Taiwan, Hong Kong and Singapore. Six factors are analysed based on aggregate data: the public/private mix of welfare programmes, the age structure, the maturity of old-age pension schemes, the population coverage of social security, the relative generosity of social security and the role of enterprises and families as alternative providers of welfare. The evidence allows putting some conventional statements about the virtues of East Asian welfare states into questions. Public expenditures on welfare are bound to rise a lot in Japan, Korea and Taiwan, while the level of protection in Hong Kong and Singapore is well below the standards of Western countries. [source] Endogenous Public Expenditures on EducationJOURNAL OF PUBLIC ECONOMIC THEORY, Issue 4 2005PETER BEARSE We construct a model of the determination of public funding of education through majority voting. Households have the option of privately supplementing public education. Alternatively, they can opt out of public education completely and choose private education. We find that in general the single-crossing property cannot be used to establish existence of a majority voting equilibrium. Numerical solutions of the model reveal (i) when public education inputs and private supplements are substitutes, private school enrollment is often zero; and (ii) the funding level for public education is very sensitive to the productivity of private supplements and the elasticity of substitution between public inputs and private supplements. [source] IS INEQUALITY HARMFUL FOR THE ENVIRONMENT IN A GROWING ECONOMY?ECONOMICS & POLITICS, Issue 1 2007HUBERT KEMPF In this paper, we investigate the relationship between inequality and the environment in a growing economy from a political-economy perspective. We consider an endogenous growth economy, where growth generates pollution and a deterioration of the environment. Public expenditures may either be devoted to supporting growth or abating pollution. The decision over the public programs is made in a direct democracy, with simple majority rule. We prove that the median voter is decisive and show that inequality is harmful for the environment: the poorer the median voter relative to the average individual, the less she will tax and devote resources to the environment, preferring to support growth. [source] Low Public Expenditures on Social Welfare: Do East Asian Countries have a Secret?INTERNATIONAL JOURNAL OF SOCIAL WELFARE, Issue 1 2000David Jacobs This paper explores the sources of low public expenditures on social welfare in Japan, Korea, Taiwan, Hong Kong and Singapore. Six factors are analysed based on aggregate data: the public/private mix of welfare programmes, the age structure, the maturity of old-age pension schemes, the population coverage of social security, the relative generosity of social security and the role of enterprises and families as alternative providers of welfare. The evidence allows putting some conventional statements about the virtues of East Asian welfare states into questions. Public expenditures on welfare are bound to rise a lot in Japan, Korea and Taiwan, while the level of protection in Hong Kong and Singapore is well below the standards of Western countries. [source] Noah and Joseph Effects in Government Budgets: Analyzing Long-Term MemoryPOLICY STUDIES JOURNAL, Issue 3 2007Bryan D. Jones This article examines the combined effects of what mathematician Benoit Mandelbrot has termed "Noah" and "Joseph" effects in U.S. national government budgeting. Noah effects, which reference the biblical great flood, are large changes or punctuations, far larger than could be expected given the Gaussian or Normal models that social scientists typically employ. Joseph effects refer to the seven fat and seven lean years that Joseph predicted to the Pharaoh. They are "near cycles" or "runs" in time series that look cyclical, but are not, because they do not occur on a regular, predictable basis. The Joseph effect is long-term memory in time series. Public expenditures in the United States from 1800 to 2004 shows clear Noah and Joseph effects. For the whole budget, these effects are strong prior to World War II (WWII) and weaker afterward. For individual programs, however, both effects are clearly detectable after WWII. Before WWII, budgeting was neither incremental nor well behaved because punctuations were even more severe and memory was not characterized by simple autoregressive properties. The obvious break that occurred after WWII could have signaled a regime shift in how policy was made in America, but even the more stable modern world is far more uncertain than the traditional incremental view. [source] The Aid Paradigm for Poverty Reduction: Does It Make Sense?DEVELOPMENT POLICY REVIEW, Issue 4 2008John Weiss Thinking on economic policy for development has undergone many shifts in response to the perceived weak results of earlier adjustment reforms. A new donor consensus has emerged based around the central themes of economic growth, good governance and social development. This article examines the logic behind this new aid paradigm, revealing a nuanced story with country circumstances playing a critical role and particular interventions varying in impact. For example, growth does not always lead to gains for the poor that match the national average; public expenditure needs to be targeted to achieve social development, but effective targeting is difficult; governance reform may be critical but there is no simple governance blueprint, and the corruption-growth association need not always be negative. [source] THE OPTIMAL PUBLIC EXPENDITURE FINANCING POLICY: DOES THE LEVEL OF ECONOMIC DEVELOPMENT MATTER?ECONOMIC INQUIRY, Issue 3 2007NILOY BOSE This paper explores how the optimal mode of public finance depends on the level of economic development. The theoretical analysis suggests that in the presence of capital market imperfection and liquidity shocks, the detrimental effect of inflation on growth is stronger (weaker) at lower (higher) levels of economic development. Consequently, income taxation (seigniorage) is a relatively less distortionary way of financing public expenditure for low-income (high-income) countries. We provide empirical support for our model's predictions using a panel of 21 Organization for Economic Cooperation and Development countries and 40 developing countries observed over the period 1972,1999. (JEL E44, E6, H6, O42) [source] TWO TAXATION AGENDAS: THE GALLOP GOVERNMENT'S FIRST TERMECONOMIC PAPERS: A JOURNAL OF APPLIED ECONOMICS AND POLICY, Issue 1 2005Michael McLure This essay reviews state taxation policy in Western Australia over the Gallop Government's first term of office. Two tax agendas emerged, one concerning reform of the State's tax system and the other concerning measures to increase the tax yield in response to mid-term fiscal stress from unanticipated growth in expenditure. It is suggested that the lack of integration of these two agendas represented a lost policy opportunity, as integration would have provided the potential to implement a much more ambitious tax reform program than that realised by the Government. The lack of integration is partly attributed to the unrealistically low forward estimates of public expenditure outlined in the Government's first budget, as this served to mask the need for additional taxation revenue (and the consequent desirability of an integrated whole-of-term taxation policy) at the very time that reform measures were being actively contemplated. As a consequence, the dominant feature of the Government's first-term tax policy was not reform, but the introduction of large mid-term revenue-raising measures, especially increases in the State's highly inefficient conveyance duty. [source] Centralisation versus Decentralisation of Public Policies: Does the Heterogeneity of Individual Preferences Matter?,FISCAL STUDIES, Issue 1 2008Carlo Mazzaferro This paper explores the role of the heterogeneity of fiscal preferences in the assignment of policy tasks to different levels of government (decentralisation versus centralisation). With reference to a sample of European countries, a median-voter mechanism of collective decision is assumed to work at both a national and a supranational level. Using data from a large international survey (the International Social Survey Programme, ISSP), a series of econometric models are estimated in order to make individual attitudes representative of different categories of public expenditure and of different countries. The dominance of decentralisation over centralisation or vice versa is determined on the basis of the utility loss that each individual suffers in connection with the distance between his or her own most preferred level of public expenditure and that chosen by the national/supranational median voter. The main finding is that, differently from the predictions of Oates's decentralisation theorem, the assignment of responsibilities at the supranational level (centralisation) for a number of public expenditure programmes (healthcare, education, unemployment benefits) dominates (or is close to dominating) decentralisation, even in the absence of economies of scale and interregional spillovers. However, when the possibility of interjurisdictional mobility is explicitly considered, in line with the predictions of Tiebout's model, decentralisation dominance becomes more and more substantial and also prevails in the sectors where, under the nonmobility assumption, the assignment of responsibilities at the supranational level is efficient. [source] Expenditure Reform in Industrialised Countries: A Case-Study Approach,FISCAL STUDIES, Issue 3 2007Sebastian Hauptmeier This study examines reforms of public expenditure in industrialised countries over the past two decades. We distinguish ambitious and timid reformers and analyse in detail reform experiences in eight case studies of ambitious reform episodes. We find that ambitious reform countries reduce spending on transfers, subsidies and public consumption. Such expenditure retrenchment is also typically part of a comprehensive reform package that includes improvements in fiscal institutions as well as structural and other macroeconomic reforms. The study finds that ambitious expenditure retrenchment and reform coincides with large improvements in fiscal and economic growth indicators. [source] Getting the Smaller Picture: Small-Area Analysis of Public Expenditure Incidence and Deprivation in Three English CitiesFISCAL STUDIES, Issue 2 2000Glen Bramley Abstract This paper examines public expenditure incidence at small-area level in cities. The motivations for such research are briefly reviewed. The article reports on an attempt at measuring public expenditure across the majority of programmes down to the level of Census wards and the actual results obtained for three urban local authorities in England. The relationship between spending, income and deprivation is examined overall and for particular spending programmes, using a number of approaches including regression-based expenditure models. The conclusions suggest that spending is indeed targetted on poorer areas but raise questions about both the strength of this relationship and how best to measure deprivation and the need to spend. [source] Socioeconomic instability and the availability of health resources: their effects on infant mortality rates in Macau from 1957,2006JOURNAL OF CLINICAL NURSING, Issue 5-6 2010Moon Fai Chan Aim., To investigate the effects of socioeconomic instability and the availability of health resources on infant mortality rate. Background., In 1960, the infant mortality rate was 46·3 infants per 1000 live births in Macau but by 2006 it had declined to 2·7 infants per 1000 live births. Design., A retrospective design collecting yearly data for the Macau covering the period from 1957,2006. The infant mortality rate was the dependent variable and demographics, socioeconomic status and health resources are three main explanatory variables to determine the mortality rate. Methods., Regression modelling. Results., Results show that higher birth (Beta = 0·029, p = 0·004) and unemployment rates (Beta = ,0·120, p = 0·036) and more public expenditure on health (Beta = ,0·282, p < 0·001) were significantly more likely to reduce the infant mortality rate. Conclusions., These results indicate that the socioeconomically disadvantaged are at a significantly higher risk for infant mortality. In contrast, more public expenditure on health resources significantly reduces the risk for infant mortality. This study provides further international evidence that suggests that improving aspects of the healthcare system may be one way to compensate for the negative effects of social inequalities on health outcomes. Relevance to clinical practice., The implication of these results is that more effort, particularly during economic downturns, should be put into removing the barriers that impede access to healthcare services and increasing preventive care for the population that currently has less access to health care in communities where there is a scarcity of medical resources. In addition, efforts should be made to expand and improve the coverage of prenatal and infant healthcare programmes to alleviate regional differences in the use of health care and improve the overall health status of infants in Macau. [source] Infrastructure Investment and Maintenance Expenditure: Optimal Allocation Rules in a Growing EconomyJOURNAL OF PUBLIC ECONOMIC THEORY, Issue 2 2009PIERRE-RICHARD AGÉNOR This paper studies the allocation of public expenditure between infrastructure investment and maintenance in an endogenous growth framework. In the basic model, maintenance spending affects both the durability and efficiency of public capital. The balanced growth path is derived and transitional dynamics associated with a revenue-neutral increase in expenditure on maintenance are analyzed. The model is then extended to account for the possibility that public spending on maintenance affects also the durability of private capital. The growth-maximizing tax rate and share of infrastructure investment are calculated in both cases. First- and second-best welfare-maximizing solutions are also discussed. [source] Speaking Softly Without Big Sticks: Meta-Regulation and Public Sector AuditLAW & POLICY, Issue 3 2003Colin Scott Australian government has undergone an "audit explosion" in the last twenty years. This article observes, first, that the constitutional function of public sector audit institutions (AIs) gives them a strong cultural commitment to the assessment of the regularity and legality of public expenditure. New functions connected with performance audit and evaluation of nonfinancial performance indicators are liable to be interpreted through the lens of these more traditional concerns. The second observation is that, if we think in terms of "regimes" of financial control, we find that AIs form only part of the overall regulatory regime. This calls into question the coherence and potential for effectiveness of regimes of financial control. However, AIs could also be conceived as "meta-regulators" with the capacity to steer the self-regulatory capacities of public sector organizations in respect of financial controls. Auditors may be effective as meta-regulators through speaking softly, even though they demonstrably lack big sticks. [source] Föderalismusreform II: Zur Frage des Controlling der KonsolidierungshilfenPERSPEKTIVEN DER WIRTSCHAFTSPOLITIK, Issue 3 2010Joachim Ragnitz One element of this reform are so called "consolidation transfers" for heavily indebted states as an measure to reduce debt. In turn, receiving states have to run a strict consolidation strategy in the years to come, that is a reduction of public expenditure. It is shown that these bail-out rules will only help if the accompanying regulations will be enforced in a restrictive matter; however. There are risks that this will not be pursued in a proper way. [source] HIV/AIDS, governance and development: the public administration factorPUBLIC ADMINISTRATION & DEVELOPMENT, Issue 1 2004Dominique Moran This paper provides an overview of the literature concerned with the impact of HIV on public administration, looking in particular at projections of the impact of HIV/AIDS on public expenditure, the impact of attrition on the health and education sectors and on the civil service as a whole. ,Success stories' such as Uganda and Senegal are discussed through their representation in the literature, and ,political commitment' is identified as a critical but under-theorised factor in tackling HIV. Having taken as its starting point the existing work on HIV and governance, the paper then considers the impact of the epidemic in conditions of state vacuum,conflict situations. The paper concludes that governance is both victim of, and part of the solution to, the problems of HIV/AIDS. Copyright © 2004 John Wiley & Sons, Ltd. [source] MIXED INDUSTRIAL STRUCTURE AND SHORT-RUN FISCAL MULTIPLIERAUSTRALIAN ECONOMIC PAPERS, Issue 2 2008ROBERTO CENSOLO Existing studies on the fiscal multiplier under imperfect competition assume a symmetric market structure with identical firms. This paper examines the fiscal policy implications of introducing a multisectoral economy, where a composite commodity is offered in many varieties within a market of monopolistic competition and a homogeneous good is produced in a perfectly competitive environment. Within the context of this mixed industrial structure we show that the size of the short-run multiplier crucially depends on the composition of public expenditure chosen by the government. [source] Imperfect Tax Compliance and the Optimal Provision of Public GoodsBULLETIN OF ECONOMIC RESEARCH, Issue 1 2003Alessandro Balestrino Our aim in this paper is to investigate whether the presence of imperfect income tax compliance affects the optimal provision of public goods within a framework in which public expenditure is financed by a general income tax that also accomplishes redistributive goals. We first derive the income tax structure, and then a generalized Samuelson rule. We argue that, under imperfect income tax compliance, it is desirable to distort public,good supply downwards, in the sense that the sum of marginal rates of substitution between public and private consumption must exceed their marginal rate of transformation. [source] The ,Feminisation of Poverty' in Costa Rica: To What Extent a Conundrum?BULLETIN OF LATIN AMERICAN RESEARCH, Issue 1 2009SYLVIA CHANT Quantitative data from Costa Rica suggest that poverty is ,feminising', especially in respect of female-headed households, who, since the early 1990s, have constituted a progressively greater share of the population classified as poor. This presents something of a conundrum given significant attempts on the part of the state to promote gender equality and to direct public expenditure to low-income women. Some light on this apparent paradox is shed by qualitative fieldwork undertaken in Guanacaste province where female headship seems to have become a more viable, and sometimes, preferred, option among women on account of its role in enhancing well-being. This is largely on account of social and legal changes that have contributed to making women less inclined to tolerate gender inequalities at the domestic level. The findings underline the importance of embracing gendered subjectivities in analyses of the ,feminisation of poverty' and invite caution about the latter being a unilaterally negative phenomenon. [source] Testing the endogenous growth model: public expenditure, taxation, and growth over the long runCANADIAN JOURNAL OF ECONOMICS, Issue 1 2001Michael Bleaney Endogenous growth models, such as Barro (1990), predict that government expenditure and taxation will have both temporary and permanent effects on growth. We test this prediction using panels of annual and period-averaged data for OECD countries during 1970,95, isolating long-run from short-run fiscal effects. Our results strongly support the endogenous growth model and suggest that long-run fiscal effects are not fully captured by period averaging and static panel methods. Unlike previous investigations, our estimates are free from biases associated with incomplete specification of the government budget constraint and do not appear to result from endogeneity of fiscal or investment variables. JEL Classification: H30, O40 Validation du modèle de croissance endogène: dépenses publiques, fiscalité et croissance à long terme. Des modèles de croissance endogène comme celui de Barro (1990) prédisent que dépenses gouvernementales et fiscalité vont avoir des effets temporaires et permanents sur la croissance. On met cette prévision au test à l'aide de données annuelles et pour certaines moyennes couvrant des sous-périodes pour les pays de l'OCDE (1970,95) dans le but de départager les effets à court et à long terme. Les résultats valident fortement le modèle de croissance endogène et suggèrent que les effets fiscaux à long terme ne sont pas pleinement capturés par des méthodes utilisant des moyennes ou des méthodes statiques. Contrairement aux résultats d'enquêtes antérieures, les résultats proposés ne souffrent pas de distorsions attribuables à une spécification incomplète de la contrainte budgétaire du gouvernement, et ne semblent pas être l'effet d'écho de l'endogénéité des variables fiscales et de l'investissement. [source] Family budgets and public money: spending fostering paymentsCHILD & FAMILY SOCIAL WORK, Issue 4 2001Derek Kirton ABSTRACT In this second of two papers based on a study of payment issues within foster care, the focus is on expenditure. It is argued that the hybrid public/private nature of fostering gives rise to contradictory pressures for carers, including the status of maintenance payments as both part of family budgets and a form of delegated public expenditure. For example, carers are required in principle both to spend fixed amounts upon foster children and to treat them in like fashion to their own children. In this paper, the issue of ,like treatment' is explored, along with the significance of payment for ,children who foster' and for relationships between carers and foster children. Also examined are the challenges presented by differences between carers' material circumstances and those of birth families, especially when reunification is planned. Overall, the paper seeks to show how the handling of expenditure becomes closely entwined with inter-personal dynamics within foster care. [source] Village Elections, Accountability and Income Distribution in Rural ChinaCHINA AND WORLD ECONOMY, Issue 6 2006Yang Yao D63; D72; H41 Abstract China has experimented with village elections for nearly 20 years. Using village and household survey data collected from 48 villages of 8 Chinese provinces for the period 1986,2002, this paper studies how the introduction of elections affects village governance and income distribution in Chinese villages. The econometric analysis finds the following outcomes. First, village elections have increased the share of public expenditure and reduced the share of administrative expenditure in the village budget, so the accountability of the elected village committee has been enhanced. Second, elections have not led to more income redistribution; instead, they have reduced the progressiveness of income redistribution. Third, elections have reduced income inequality measured by the Gini coefficient in villages. The reduction is equivalent to 5.7 percent of the sample average, or 32 percent of the growth of the Gini coefficient in the period of 1987-2002. Because village elections have not led to more income redistribution, this positive effect must have come from more public investment, which benefits the poor more than wealthier people. The general conclusion that we draw from our results is that, despite institutional constraints, village elections have improved village governance and the life of villagers. (Edited by Xinyu Fan) [source] Analysing Macro-Poverty Linkages of External Liberalisation: Gaps, Achievements and AlternativesDEVELOPMENT POLICY REVIEW, Issue 3 2005Bernhard G. Gunter CGE modelling has dominated analysis of the impact of external liberalisation on poverty. This article provides a structuralist critique of standard neo-classical CGE models. It highlights five sets of gaps and partial achievements in the modelling of issues affecting the poverty impact of macroeconomic policies: duality and structural rigidities; efficiency gains and quota rents; the investment and savings specification; the nature of public expenditures; and the modelling of financial fragility, risk premia and issues of credibility. It outlines a model that makes it possible to analyse more plausible stories about the impact of both current and capital account liberalisation and questions the realism of existing approaches to ex-ante poverty impact assessment. [source] Minimization of socioeconomic disruption for displaced populations following disastersDISASTERS, Issue 3 2010Omar El-Anwar In the aftermath of catastrophic natural disasters such as hurricanes, tsunamis and earthquakes, emergency management agencies come under intense pressure to provide temporary housing to address the large-scale displacement of the vulnerable population. Temporary housing is essential to enable displaced families to reestablish their normal daily activities until permanent housing solutions can be provided. Temporary housing decisions, however, have often been criticized for their failure to fulfil the socioeconomic needs of the displaced families within acceptable budgets. This paper presents the development of (1) socioeconomic disruption metrics that are capable of quantifying the socioeconomic impacts of temporary housing decisions on displaced populations; and (2) a robust multi-objective optimization model for temporary housing that is capable of simultaneously minimizing socioeconomic disruptions and public expenditures in an effective and efficient manner. A large-scale application example is optimized to illustrate the use of the model and demonstrate its capabilities ingenerating optimal plans for realistic temporary housing problems. [source] Fragmentation and Sprawl: Evidence from Interregional AnalysisGROWTH AND CHANGE, Issue 3 2002John I. Carruthers Recent years have witnessed widespread expansion of state and regional planning programs in the United States. A major purpose of these efforts is to reduce urban sprawl,low density, discontinuous, suburban,style development, often characterized as the result of rapid, unplanned, and/or uncoordinated growth, by promoting jurisdictional cooperation and regulatory consistency across metropolitan areas. This paper evaluates the efficacy of this approach by examining the relationship between governmental fragmentation and several measurable outcomes of urban development: density, urbanized land area, property value, and public expenditures on infrastructure. The four dimensions are modeled in a simultaneous equations framework, providing substantive evidence on how fragmentation and other exogenous factors affect metropolitan growth patterns. Fragmentation is associated with lower densities and higher property values, but has no direct effect on public service expenditures; less fragmented metropolitan areas occupy greater amounts of land due to the extensive annexation needed to bring new development under the control of a central municipality. The findings of the analysis lend support to state and regional planning efforts aimed at increasing cooperation among local governments, but also suggest that further research is needed in order to evaluate whether or not they produce their intended effects. [source] Costs and determinants of privately financed home-based health care in Ontario, CanadaHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 2 2008Denise N. Guerriere PhD Abstract The Canadian context in which home-based healthcare services are delivered is characterised by limited resources and escalating healthcare costs. As a result, a financing shift has occurred, whereby care recipients receive a mixture of publicly and privately financed home-based services. Although ensuring that care recipients receive efficient and equitable care is crucial, a limited understanding of the economic outcomes and determinants of privately financed services exists. The purposes of this study were (i) to determine costs incurred by families and the healthcare system; (ii) to assess the determinants of privately financed home-based care; and (iii) to identify whether public and private expenditures are complements or substitutes. Two hundred and fifty-eight short-term clients (< 90 days of service utilisation) and 256 continuing care clients (> 90 days of utilisation) were recruited from six regions across the province of Ontario, Canada, from November 2003 to August 2004. Participants were interviewed by telephone once a week for 4 weeks and asked to provide information about time and monetary costs of care, activities of daily living (ADL), and chronic conditions. The mean total cost of care for a 4-week period was $7670.67 (in 2004 Canadian dollars), with the overwhelming majority of these costs (75%) associated with private expenditures. Higher age, ADL impairment, being female, and a having four or more chronic conditions predicted higher private expenditures. While private and public expenditures were complementary, private expenditures were somewhat inelastic to changes in public expenditures. A 10% increase in public expenditures was associated with a 6% increase in private expenditures. A greater appreciation of the financing of home-based care is necessary for practitioners, health managers and policy decision-makers to ensure that critical issues such as inequalities in access to care and financial burden on care recipients and families are addressed. [source] Publicly funded medical savings accounts: expenditure and distributional impacts in Ontario, CanadaHEALTH ECONOMICS, Issue 10 2008Jeremiah Hurley Abstract This paper presents the findings from simulations of the introduction of publicly funded medical savings accounts (MSAs) in the province of Ontario, Canada. The analysis exploits a unique data set linking population-based health survey information with individual-level information on all physician services and hospital services utilization over a four-year period. The analysis provides greater detail along three dimensions than have previous analyses: (1) the distributional impacts of publicly funded MSAs across individuals of differing health statuses, incomes, ages, and current expenditures; (2) the impact of differing degrees of risk adjustment for MSA contributions; and (3) the impact of MSA funding over multiple years, incorporating year-to-year variation in spending at the individual level. In addition, it analyses more plausible designs for publicly funded MSAs than the existing studies. Government uses information available from year t,,,1 to allocate its budget for year t in a manner that is ex ante fiscally neutral for the public sector: the government first withholds funds equal to expected catastrophic insurance payments under the MSA plan, and then allocates only the balance to individual MSA accounts. The government captures the savings associated with reduced health-care utilization under MSAs and we examine deductibles that vary by income rather than by current health-care expenditures. The impacts on public expenditures under these designs are more modest than in the previous studies and under plausible assumptions MSAs are predicted to decrease public expenditures. MSAs, however, are also predicted to have unavoidable negative distributional consequences with respect to both public expenditures and out-of-pocket spending. Copyright © 2007 John Wiley & Sons, Ltd. [source] Low Public Expenditures on Social Welfare: Do East Asian Countries have a Secret?INTERNATIONAL JOURNAL OF SOCIAL WELFARE, Issue 1 2000David Jacobs This paper explores the sources of low public expenditures on social welfare in Japan, Korea, Taiwan, Hong Kong and Singapore. Six factors are analysed based on aggregate data: the public/private mix of welfare programmes, the age structure, the maturity of old-age pension schemes, the population coverage of social security, the relative generosity of social security and the role of enterprises and families as alternative providers of welfare. The evidence allows putting some conventional statements about the virtues of East Asian welfare states into questions. Public expenditures on welfare are bound to rise a lot in Japan, Korea and Taiwan, while the level of protection in Hong Kong and Singapore is well below the standards of Western countries. [source] | ||||||||||||||||||||||||||||